Non-Operative Treatment of Hip Pain

Initial Evaluation in the Office

Dr. Kelly performs a thorough clinical evaluation on each patient that includes three major parts: history, physical examination, and imaging. The history is a focused conversation about the duration of symptoms, location of pain, aggravating factors, and previous injuries or surgery to the hip. Next, Dr. Kelly will examine the hip, focusing on areas of tenderness, painful positions of the hip, decreased range of motion, as well as a focused examination of the lumbar spine. Finally, x-rays of the hip are reviewed which provide additional information about the health of the knee joint.

What is Dr. Kelly’s approach to care?

Dr. Kelly strongly believes that all patients should try some form of non-operative treatment below. These treatment options can provide significant improvement in symptoms without any risks associated with surgery. In fact, the vast majority of people who are treated in the office never receive surgery and respond well to the treatment options below!

Can I still exercise if my hip hurts?

Yes! As the saying goes, “motion is lotion.” We want our patients to remain active. High impact exercises like running or jogging may cause more pain in the hip compared to low impact exercises like biking or swimming. We can work with you to find a way to remain active and limit pain in your hip.

Non-operative Treatment Options for Hip Arthritis

1. Physical Therapy – A skilled physical therapist can evaluate a patient to understand each patient’s unique needs. He or she can then help develop strategies to strengthen muscles around the hip to improve mobility and reduce pain. Sometimes patient are able to increase their range of motion of the hip. Physical therapist can provide helpful advice for difficulty with common tasks such as climbing stairs and getting up from a low seat. After a few sessions, most people are able to transition to exercises at home.
2. Weight Management – Weight management is critical for reducing the pain associated with hip arthritis. Losing weight will reduce the stress on the hip joint and decrease progression of arthritis. Our team often recommends focusing on diet and low impact or water-based exercise to help lose weight and reduce the stress on your hip.
3. Medication – Acetaminophen (Tylenol) is an over-the-counter medication that can help treat mild pain from osteoarthritis. Other medication include anti-inflammatory drugs to reduce inflammation associated with arthritis. Common examples include ibuprofen (Advil), diclofenac (Voltaren), and meloxicam (Mobic). These medications do have adverse effects so each patient should consider these risks before trying them.
4. Assistive Devices – Assistive devices such as a cane or walker help reduce stress on the hip joint. Additionally it provides support to reduce the risk of falls. These devices can be used selectively to help patients when they need to be particularly active.
5. Injections – Hip injections should be used very cautiously due to poor efficacy as well as risk of complication. Cortisone injections reduce inflammation and may provide short-term relief of pain and symptoms. However, a small percentage of patients may experience avascular necrosis of the femoral head which is a serious complication that reduces blood flow to the femoral head. In certain cases in which the diagnosis is uncertain between hip arthritis or lumbar spine issue, a lidocaine injection without cortisone can be used for diagnostic purposes without the risk of avascular necrosis.